Medication adherence self-report instruments: implications for practice and research.
BACKGROUND
After an acute cardiac event, adhering to recommendations for pharmacologic therapy is important in achieving optimal health outcomes. Considering the impressive evidence base for cardiovascular pharmacotherapy, strategies for promoting adherence are less well developed. Furthermore, accessing reliable, valid, and cost-effective mechanisms of monitoring adherence in the research and clinical settings is challenging.


OBJECTIVE
The aim of this article was to review published self-report measures assessing and monitoring medication adherence in cardiovascular disease and provide recommendations for research into medication adherence.


METHODS
The electronic databases CINAHL, Medline, and Science Direct were searched using the key search terms medication adherence and/or compliance, cardiovascular, self-report measures, and questionnaires. The World Wide Web was searched using the Google and Google Scholar search engines, and reference lists of retrieved documents were reviewed. The search strategy was verified by a health librarian. Instruments were included if they specifically addressed medication adherence as a discrete construct rather than a disease-specific or a generic health status measurement.


RESULTS
Despite of the problems with medication adherence identified in the literature, only 7 instruments met the search criteria. There was limited use of instruments across studies and settings to enable comparison across populations and extensive psychometric evaluation.


CONCLUSIONS
Medication adherence is a complex, multifaceted construct dependent on a range of physical, social, economic, and psychological considerations. In spite of the importance of adherence in ensuring optimal cardiovascular outcomes, conceptual underpinnings and methods of assessing medication adherence require further discussion and debate.
Rolley
John X
JX
Cardiovascular and Chronic Care, School of Nursing and Midwifery, Curtin University of Technology, Sydney Campus, Australia. john.rolley@postgrad.curtin.edu.au
Davidson
Patricia M
PM
Dennison
Cheryl R
CR
Ong
Andrew
A
Everett
Bronwyn
B
Salamonson
Yenna
Y
D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000523:psychology; D003362:Cost-Benefit Analysis; D003625:Data Collection / Q000379:methods* / Q000592:standards; D016903:Drug Monitoring / Q000379:methods; D055318:Evidence-Based Nursing; D006801:Humans; D008403:Mass Screening / Q000379:methods; D055118:Medication Adherence / Q000523:psychology; D009730:Nursing Assessment / Q000379:methods* / Q000592:standards; D015403:Nursing Evaluation Research; D011594:Psychometrics; D015203:Reproducibility of Results; D012648:Self Care; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires / Q000592:standards